HESI RN NEXT GENERATION NCLEX ACCURATE
COMPREHENSIVE PRACTICE EXAM WITH ALL
POSSIBLE APPROVED WELL ELABORATED
PRACTICE QUESTIONS AND 100% CORRECT
VERIFIED ANSWERS WITH DETAILED RATIONALES
PLUS EXPERT ANSWER KEY (100% CORRECT
VERIFIED SOLUTIONS) 2026-2027 CURRENTLY
UPDATED VERSION Q&A GUARANTEED PASS A+
INSTANT DOWNLOAD PDF
1. The nurse is caring for a client with heart failure who is prescribed furosemide.
Which laboratory value is most important to monitor?
A. Serum sodium
B. Serum potassium
C. Serum calcium
D. Serum magnesium
B. Serum potassium
Rationale: Furosemide is a loop diuretic that causes significant potassium loss.
Hypokalemia can lead to life-threatening cardiac dysrhythmias, making
potassium monitoring a priority.
,2. A client with type 1 diabetes mellitus is admitted with a blood glucose level of
450 mg/dL. Which assessment finding indicates a complication of diabetic
ketoacidosis?
A. Tremors and diaphoresis
B. Deep, rapid respirations
C. Bradycardia and hypotension
D. Hypertension and flushed skin
B. Deep, rapid respirations
Rationale: Kussmaul respirations (deep, rapid) are the body's compensatory
response to metabolic acidosis from ketone accumulation in diabetic
ketoacidosis.
3. The nurse is preparing to administer digoxin to a client. The apical pulse is 58
beats per minute. What is the nurse's priority action?
A. Administer the medication as prescribed
B. Withhold the medication and notify the provider
C. Recheck the pulse in 15 minutes
D. Administer the medication and monitor for toxicity
B. Withhold the medication and notify the provider
Rationale: Digoxin should be withheld when the apical pulse is below 60 beats
per minute in adults due to the risk of worsening bradycardia and toxicity.
4. A client is receiving a blood transfusion. Fifteen minutes into the transfusion,
the client reports flank pain and chills. What is the nurse's first action?
A. Slow the transfusion rate
B. Administer antipyretics as prescribed
C. Stop the transfusion and maintain IV access with normal saline
D. Notify the healthcare provider and continue the transfusion
C. Stop the transfusion and maintain IV access with normal saline
,Rationale: Flank pain and chills indicate a possible hemolytic transfusion
reaction. The immediate priority is to stop the blood to prevent further reaction
while keeping IV access for emergency medications.
5. The nurse is assessing a client with a fractured femur. The client suddenly
reports chest pain and difficulty breathing. Which complication is the nurse most
concerned about?
A. Pneumonia
B. Fat embolism
C. Compartment syndrome
D. Pulmonary edema
B. Fat embolism
Rationale: Fat embolism syndrome typically occurs 24-72 hours after long bone
fractures. Symptoms include chest pain, dyspnea, and altered mental status.
6. A client with acute pancreatitis is reporting severe abdominal pain. Which
position should the nurse encourage to provide comfort?
A. Supine with legs flat
B. Side-lying with knees flexed
C. Prone position
D. High-Fowler's position
B. Side-lying with knees flexed
Rationale: The side-lying position with knees flexed (fetal position) decreases
tension on the abdominal muscles and reduces pain in pancreatitis.
7. The nurse is caring for a client with a chest tube connected to a water-seal
drainage system. Which finding indicates the system is functioning correctly?
A. Continuous bubbling in the water-seal chamber
B. Gentle, intermittent bubbling in the water-seal chamber
, C. A sudden increase in bubbling with a rise in the water level
D. The drainage system is clamped for 30 minutes each hour
B. Gentle, intermittent bubbling in the water-seal chamber
Rationale: Gentle intermittent bubbling is expected as air is expelled.
Continuous bubbling may indicate an air leak, while a sudden increase suggests
a new leak or disconnection.
8. A client with chronic kidney disease is prescribed a low-protein diet. The nurse
explains that the purpose of this dietary restriction is to:
A. Prevent fluid overload
B. Decrease the workload on the kidneys
C. Reduce the risk of hyperkalemia
D. Increase calcium absorption
B. Decrease the workload on the kidneys
Rationale: Protein metabolism produces waste products that are excreted by the
kidneys. Restricting protein reduces the buildup of urea and creatinine, thereby
decreasing kidney workload.
9. The nurse is assessing a client who has just returned from a thyroidectomy.
Which assessment finding should be reported to the provider immediately?
A. Mild hoarseness of the voice
B. Tingling in the fingers and toes
C. A serum calcium level of 9.2 mg/dL
D. Serosanguineous drainage on the dressing
B. Tingling in the fingers and toes
Rationale: Tingling in the fingers and toes may indicate hypocalcemia due to
accidental removal of the parathyroid glands, which can cause tetany and
laryngeal spasm.
COMPREHENSIVE PRACTICE EXAM WITH ALL
POSSIBLE APPROVED WELL ELABORATED
PRACTICE QUESTIONS AND 100% CORRECT
VERIFIED ANSWERS WITH DETAILED RATIONALES
PLUS EXPERT ANSWER KEY (100% CORRECT
VERIFIED SOLUTIONS) 2026-2027 CURRENTLY
UPDATED VERSION Q&A GUARANTEED PASS A+
INSTANT DOWNLOAD PDF
1. The nurse is caring for a client with heart failure who is prescribed furosemide.
Which laboratory value is most important to monitor?
A. Serum sodium
B. Serum potassium
C. Serum calcium
D. Serum magnesium
B. Serum potassium
Rationale: Furosemide is a loop diuretic that causes significant potassium loss.
Hypokalemia can lead to life-threatening cardiac dysrhythmias, making
potassium monitoring a priority.
,2. A client with type 1 diabetes mellitus is admitted with a blood glucose level of
450 mg/dL. Which assessment finding indicates a complication of diabetic
ketoacidosis?
A. Tremors and diaphoresis
B. Deep, rapid respirations
C. Bradycardia and hypotension
D. Hypertension and flushed skin
B. Deep, rapid respirations
Rationale: Kussmaul respirations (deep, rapid) are the body's compensatory
response to metabolic acidosis from ketone accumulation in diabetic
ketoacidosis.
3. The nurse is preparing to administer digoxin to a client. The apical pulse is 58
beats per minute. What is the nurse's priority action?
A. Administer the medication as prescribed
B. Withhold the medication and notify the provider
C. Recheck the pulse in 15 minutes
D. Administer the medication and monitor for toxicity
B. Withhold the medication and notify the provider
Rationale: Digoxin should be withheld when the apical pulse is below 60 beats
per minute in adults due to the risk of worsening bradycardia and toxicity.
4. A client is receiving a blood transfusion. Fifteen minutes into the transfusion,
the client reports flank pain and chills. What is the nurse's first action?
A. Slow the transfusion rate
B. Administer antipyretics as prescribed
C. Stop the transfusion and maintain IV access with normal saline
D. Notify the healthcare provider and continue the transfusion
C. Stop the transfusion and maintain IV access with normal saline
,Rationale: Flank pain and chills indicate a possible hemolytic transfusion
reaction. The immediate priority is to stop the blood to prevent further reaction
while keeping IV access for emergency medications.
5. The nurse is assessing a client with a fractured femur. The client suddenly
reports chest pain and difficulty breathing. Which complication is the nurse most
concerned about?
A. Pneumonia
B. Fat embolism
C. Compartment syndrome
D. Pulmonary edema
B. Fat embolism
Rationale: Fat embolism syndrome typically occurs 24-72 hours after long bone
fractures. Symptoms include chest pain, dyspnea, and altered mental status.
6. A client with acute pancreatitis is reporting severe abdominal pain. Which
position should the nurse encourage to provide comfort?
A. Supine with legs flat
B. Side-lying with knees flexed
C. Prone position
D. High-Fowler's position
B. Side-lying with knees flexed
Rationale: The side-lying position with knees flexed (fetal position) decreases
tension on the abdominal muscles and reduces pain in pancreatitis.
7. The nurse is caring for a client with a chest tube connected to a water-seal
drainage system. Which finding indicates the system is functioning correctly?
A. Continuous bubbling in the water-seal chamber
B. Gentle, intermittent bubbling in the water-seal chamber
, C. A sudden increase in bubbling with a rise in the water level
D. The drainage system is clamped for 30 minutes each hour
B. Gentle, intermittent bubbling in the water-seal chamber
Rationale: Gentle intermittent bubbling is expected as air is expelled.
Continuous bubbling may indicate an air leak, while a sudden increase suggests
a new leak or disconnection.
8. A client with chronic kidney disease is prescribed a low-protein diet. The nurse
explains that the purpose of this dietary restriction is to:
A. Prevent fluid overload
B. Decrease the workload on the kidneys
C. Reduce the risk of hyperkalemia
D. Increase calcium absorption
B. Decrease the workload on the kidneys
Rationale: Protein metabolism produces waste products that are excreted by the
kidneys. Restricting protein reduces the buildup of urea and creatinine, thereby
decreasing kidney workload.
9. The nurse is assessing a client who has just returned from a thyroidectomy.
Which assessment finding should be reported to the provider immediately?
A. Mild hoarseness of the voice
B. Tingling in the fingers and toes
C. A serum calcium level of 9.2 mg/dL
D. Serosanguineous drainage on the dressing
B. Tingling in the fingers and toes
Rationale: Tingling in the fingers and toes may indicate hypocalcemia due to
accidental removal of the parathyroid glands, which can cause tetany and
laryngeal spasm.
